Individual provider Active NPI

Abbie Kim Bates, DNP

  • Psychiatry Physician
  • San Clemente, CA
National Provider Identifier
1073338521
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
95032644 Issued in CA
Practice address
1401 N El Camino Real Ste 100
San Clemente, CA 92672-4983
Phone
(858) 522-0145
NPI assigned
Nov 20, 2024
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 95032644 CA Primary

Addresses

Primary practice location

1401 N El Camino Real Ste 100
San Clemente, CA 92672-4983

Mailing address

611 W G St Unit 221
San Diego, CA 92101-5953
Phone (425) 205-7675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251125004512 CA Practitioner - Nurse Practitioner 7416449525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brittany Watson NP Nursing CorporationGroup PAC ID 9335592211, 7 clinicians

Practice addresses (Care Compare)

4420 Hotel Circle CT
Suite 200
San Diego, CA 92108-3423
Phone (858) 522-0145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032644CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brittany Watson NP Nursing Corporation Psychiatry CurrentSince Nov 1, 2025 Accepting new patients
Oc Couple and Family Therapy PastSince May 26, 2024 Accepting new patients

Locations

101 S El Camino Real
Ste 106
San Clemente, CA 92672
Phone (858) 522-0145

1401 N El Camino Real
Ste 100
San Clemente, CA 92672
Phone (858) 522-0145

4420 Hotel Circle Ct
Ste 200
San Diego, CA 92108
Phone (619) 933-2165

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1073338521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W G ST UNIT 221",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015953",
            "telephone_number": "425-205-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N EL CAMINO REAL STE 100",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724983",
            "telephone_number": "858-522-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "ABBIE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "95032644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.